Background <p>Labia minora reduction is a unique cosmetic surgical procedure for women. Whether patients with different surgical motivations have the same postoperative satisfaction is a confusing clinical question.</p> Methods <p>This study aimed to use a self-made questionnaire to determine the factors that affect patient satisfaction after labia minora reduction surgery.</p> Results <p>This retrospective study analysed patients who underwent labia minora reduction at an outpatient clinic in China. Questionnaire responses were collected via phone, text message, or email 6 months after the surgery. A total of 49 questionnaires were collected. After an average follow-up of 51.03 months, 95.92% of patients would choose the surgery again under the same preoperative conditions. Different preoperative surgical motivations were not independent risk factors affecting postoperative patient satisfaction. The level of understanding of the surgery before the operation had a significant impact on patients’ satisfaction with the appearance, movement, and comfort of wearing clothes of the labia minora, as well as overall satisfaction. Delayed healing of postoperative incisions had a significant impact on patients’ postoperative satisfaction with appearance, movement, comfort of wearing clothes, and overall satisfaction. Significant scarring of postoperative incisions had a significant effect on patients’ satisfaction with postoperative appearance and comfort of movement.</p> Conclusions <p>Adequate preoperative communication with patients, delayed wound healing, and significant scarring at the incision site are independent factors that affect patient satisfaction with labia minora reduction.</p> Level of Evidence IV <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>